School boards across Ky. realign school-nurse programs, squeezed by budget cuts and Medicaid payment issues

School districts in Kentucky have long relied on county health departments for school nurses, but state budget cuts and problems with Medicaid reimbursements have squeezed the health agencies, and they in turn have put the squeeze on the schools for more money and other measures.

Despite some concerns, the Russell County Schools board voted to approve a contract with the Lake Cumberland District Health Department to provide school nursing services. Corbin Independent Schools did not continue its normal contract with the Whitley County Health Department for these services, and has employed its own nurses this year instead. Fayette County Schools will coordinate a hybrid, scaled-back program with the Lexington-Fayette County Health Department, rather than relying solely on the department for services.

The Russell County board had tabled its contract with the Lake Cumberland department last month due to concerns about a lack of provisions allowing for reimbursement if the nurse ever had to take time off, reports John Thompson of The Times Journal in Russell Springs. Superintendent Michael Ford said the health department was unwilling at this time to accept such provisions, but that it has not been a problem in the past.

Ford also said the district would get the same services if it hired its own school nurse. So, in the face of concerns from many members, the board voted last week to continue providing school-nurse services through the department, Thompson reports.

On the other hand, Corbin is hiring its own nurses. Its health-department contract ended in May because the department went months without receiving Medicaid reimbursements for school-nursing services, and the department had no financial resources to continue them, reports Jeff Noble of The Times Tribune.

Citing cuts in federal funding, Fayette County Schools has scaled back its school-nurse program. The joint program between the school system and the local health department will go from having 30 registered nurses for school services to operating with 13 registered nurses and 14 licensed practical nurses, reports Jim Warren of the Lexington Herald-Leader.

Fayette Superintendent Tom Shelton said last week that the plan is to supplement the nurses with other health care providers or additional help from the department; school personnel will also help by administering some medication.

This is a temporary solution to meet school nursing needs to give the schools time to develop a permanent solution, Shelton told Warren. Shelton said he wants to develop a completely new model for providing nursing services after next year.